The New Statesman Interview - Robert Winston
He may be held in awe at No 10, but God's imitator thinks new Labour has made a hash of the health s
The nation wheezes. The NHS creaks. How, one wonders, will the health service cope with the forthcoming genetic revolution when it can barely handle flu? I expect Lord Winston to cite the current Lemsip-and-Kleenex crisis as the harbinger of a dawning catastrophe in his own field, but he seems almost strangely distracted from the future of gene science.
Robert Winston is the country's leading fertility expert and a pioneer of IVF treatment and pre-implantation techniques to screen out inherited disease. Ennobled by Tony Blair and almost sanctified by the BBC, he achieved star status in his television series, The Human Body, in which the screen death of an elderly man contrived the remarkable feat of making snuff TV respectable. Although scornful of right-wing charges of assumed divinity, Winston has modestly conceded to being "God's imitator".
If playing Rory Bremner to the Almighty suggests flimsiness, then it should not. Despite criticism - and his success and bullishness have attracted plenty - Winston is regarded with an awe that is said to extend even unto 10 Downing Street. It seems strange therefore that Winston, a staunch believer in new Labour, and the chair of the Lords' select committee on science and technology, should be so damning of the government's record on health.
We start on his own province and the patchy, postcode provision of fertility treatment. "There's an inevitable disappointment that, when we were in opposition, the Labour Party was making really encouraging noises about improving reproductive medicine. The truth is that our services are much the worst in Europe. There are fewer IVF treatment cycles under this government than there were under the Tories.
"That is a pretty uncomfortable feeling for someone who takes the Labour whip in the Lords, who has tried to run an NHS service for 20 years, who has redistributed all private income through the unit [his Hammersmith Hospital centre]. One could not be anything but unhappy about that." Winston's misery does not end there. In his view, Blair's health reforms have eroded specialist care, failed to eradicate the Conservative internal market and offered a cash provision that is "not as good as Poland's".
"We still have an internal market, but instead of commissioning by local health authorities, we have primary care groups. I think we've been quite deceitful about it. We haven't told the truth, and I'm afraid there will come a time when it will be impossible to disguise the inequality of the health service from the general population. We gave categorical promises that we would abolish the internal market. We have not done that. Our reorganisation of the health service was . . . very bad. We have made medical care deeply unsatisfactory for a lot of people. We've always had this right but monolithic view that there should be equality throughout the nation at the point of delivery. All very good stuff, but it isn't working."
His prescription is root-and-branch reform. "It's not good enough to say we're going to spend £20 billion over 35 years or whatever. It's a question of changing the whole way the package is funded. Do we want a health service that is steadily going to de-teriorate and be more and more rationed and will be inferior on vital areas such as heart disease and cancer compared to our less well-off neighbours? That is where we are going at the moment. If we don't want that, then we pay more tax or have an insurance system. I see no alternative.There is a lot wrong with the health service, and no one is prepared to say so. I shouldn't really be saying these things to you now."
Does he consider healthcare worse than under the Tories? "It's just gradually deteriorating because we blame everything on the previous government." And why has Blair so signally failed to address the crisis? "I don't think he's been informed about what's happening. I don't think he knows. I think there is a conspiracy of silence. I don't believe he would allow this. I think he is a good man. I don't think he realises how frustrated we are."
The "we" to whom he refers appears not principally to mean senior doctors who seek jobs in vain and who, in his own unit, preside over empty operating theatres. ("We are no longer able to train people because we don't have the clinical throughput. That happens in a whole range of specialist areas. All that has disintegrated." And he claims that his particular area of expertise - Fallopian tube surgery - apparently faces semi-extinction. "It is a dying art," he says, as if he were a wheelwright.)
But his "we" is a collective of the ordinary and his indictment is based not only on professional frustration but also on personal experience. A few weeks ago, his 87-year-old mother, a diabetic, was admitted to hospital. "She waited 13 hours in casualty before getting a bed in a mixed-sex ward - a place we said we would abolish. None of her drugs were given on time, she missed meals and she was found lying on the floor when the morning staff came on. She caught an infection and she now has an ulcer on her leg." As Winston acknowledges, there is nothing unusual about this litany. "It is normal. The terrifying thing is that we accept it."
Although he stresses the government's upside - good on poverty and primary healthcare - one senses grave disillusion. Winston, far removed from the showman doctor I had expected, offers little hubris, even on his own work. His pre-implantation programme to detect inherited disease is going "modestly well".
"To give someone a normal embryo from the same batch saves the NHS thousands of pounds, but they won't generally fund it because . . . the child is not going to die of muscular dystrophy this year, and it's all short-term thinking."
On "therapeutic cloning" - growing replacement human tissue from stem cells - the government is simply pusillanimous. "They seem frightened of the right-to-life groups. If you could use the tissue from one human embryo to save hundreds of lives, there must be a moral imperative to do it, but they have refused to grasp the nettle. Numerically we have a very strong government, but it is behaving in an incredibly weak fashion. Tissue engineering is a good example of how an important resource, in which we could lead, could be lost to the country."
Winston now conducts much of his research in California, where he is working on the genetic modification of animal organs for human transplantation. But he is in no sense a brave new worlder. Rather, he is an oddly conservative father of three, whose touchstones are a contented marriage, Orthodox Judaism, fine wine and the Arsenal.
Although he is unexpectedly likeable, his professions of fondness for others are frequently back-loaded with a sting. Take Margaret Jay, for example. "She is a wonderful woman; intelligent, witty, a wonderful leader in the Lords. But actually I think she was wrong about the hereditaries . . . I don't think their dismissal reflects any of her talents. There was a way of doing what we did with a good deal more kindness and grace."
Though opposed to the hereditary principle, Winston has argued the difficulty of devising a better Upper House. Now, as Lord Wakeham's royal commission prepares to report, he is even more scathing. "There are all sorts of things in Britain that need reform. I think we picked on the House of Lords because it was a high- profile, low-risk area. The idea that the Lords wasn't democratic and the Commons is, is a nonsense. When we talk about democracy, it's a huge amount of cant. What we did was not strictly honest, and that's what stuck in my throat. The hereditaries made as much of a contribution as people like me."
Although he admits to being chosen "on a fluke of patronage", he has little enthusiasm for an elected majority; fearing an influx of clubbable and elevated figures with little to offer.While others may view as undemocratic or naive his view that "a really independent appointment body" could filter out placemen, his views at least have the merit of some originality; a quality he finds largely absent in modern politics.
"There are very few original political thinkers. I think Gordon Brown possibly is, and to some extent Tony Blair, but there aren't many." He appears a genuine admirer of Blair. "When you get away from all the hype, all the spin, I think there is someone there who's quite capable of greatness." Although he denies reports that he is close to the Prime Minister, he seems to have an informed interest in the goings-on at No 10. When I tell him a horror story about Chelsea and Westminster Hospital, he puts his hand over the tape recorder and says confidingly: "Oh, that's where Cherie Blair is having her Caesarean section."
Gossip apart, he sees himself as always the outsider. "I have never joined the club. People like me are not popular with our colleagues." That is not wholly true, although Winston has been criticised; notably for his volte-face on issues such as IVF, which he at first deemed a non-starter. On this, and other about-turns, he takes the Keynesian line. "Someone who doesn't change his mind is useless. If I see an argument is wrong, I'll admit it."
One can see how his outspokenness might offend. On individuals, he is charitable about Frank Dobson - "a good man, but the health service was already out of control" - but cool about Dobson's successor, Alan Milburn. Lord Puttnam, whom we pass in the corridor, is affectionately pointed out as "Blair's babe".
For all his fealty to the leader and the Labour Party, Winston could never be so labelled.
I had expected the sort of outspokenness befitting a prophet of gene science and a messiah for the new millennium. Instead I got the reflections of one more disillusioned consultant; one more middle-aged man whose elderly mother was found huddled on the floor of an overcrowded ward. As Winston says, any number of people might offer a similar testimony. But nobody listens to them.